Which measure is primarily used to evaluate patient experience in plan evaluations?

• A. Readmission rate
• B. CAHPS
• C. HEDIS
• D. A1C

Answer: (B)

Measuring patient experience requires a standardized, validated survey that captures how members perceive and interact with their health plan. CAHPS provides exactly that by asking about access to care, communication with providers, customer service, and overall satisfaction with the plan. It’s designed specifically to quantify member experiences and is widely used for plan comparisons and reporting.

Readmission rate looks at hospital-level outcomes and utilization, which reflect system performance and clinical processes more than the patient’s subjective experience. HEDIS is a broad set of performance measures that includes many clinical and care-process metrics, not primarily focused on patient experience. A1C is a clinical biomarker for diabetes control, not an experience measure.

Because the question focuses on patient experience in plan evaluations, CAHPS is the most appropriate measure.